# Pulmonary Embolism Post-Bioprosthetic Aortic Valve Replacement: A Case Report

## TL;DR

A 76-year-old woman developed pulmonary embolism two weeks after a second bioprosthetic aortic valve replacement, highlighting the need for close monitoring and possibly stronger anticoagulation in high-risk patients.

## Contribution

This case report highlights pulmonary embolism as a rare but important complication following bioprosthetic valve replacement, particularly in high-risk patients.

## Key findings

- Pulmonary embolism occurred 14 days after a second bioprosthetic valve replacement in a 76-year-old woman.
- The patient was on aspirin monotherapy post-surgery but was later started on warfarin.
- High-risk factors like advanced age and prior valve failure may increase embolism risk.

## Abstract

Pulmonary embolism is a rare complication post-bioprosthetic valve replacement, which is seldom reported in the literature.

A 76-year-old woman was admitted to our institution with a diagnosis of pulmonary embolism, occurring 14 days after undergoing a second bioprosthetic valve replacement, which had been performed due to failure of the initial prosthesis. Postoperatively, the patient had been managed with aspirin monotherapy for the prevention of thromboembolic events. Transthoracic echocardiography demonstrated normal age-related diastolic function, a left ventricular ejection fraction of 59%, no evidence of bioprosthetic valve stenosis, and overall satisfactory prosthetic valve function. The patient was discharged on the eighth hospital day with the initiation of warfarin therapy.

It is crucial to closely monitor for clinical signs and symptoms of thromboembolism, such as pulmonary embolism, following bioprosthetic valve implantation, particularly in patients with high-risk factors including advanced age, female sex, hypertension, and a history of previous valve implantation failure. In such cases, clinicians should also consider intensifying antiplatelet or anticoagulation therapy beyond standard daily low-dose aspirin.